Patient Account Representative

4 days ago

Helena, Montana, United States The Staff Pad Full time
Job Title: Patient Account Representative

The Staff Pad is seeking a highly skilled Patient Account Representative to join our team in Helena, Montana. As a Patient Account Representative, you will play a critical role in ensuring the successful outcome of claim submissions and payments.

Responsibilities:
  1. Perform pre-billing and billing functions to ensure accurate and timely claim submissions.
  2. Follow all billing and regulatory guidelines to ensure facility compliance.
  3. Collaborate with team members to ensure accurate and timely billing.
  4. Collect outstanding insurance company balances using collection best practices.
  5. Utilize A/R reports to target aged balances for collection.
  6. Evaluate partial payments to determine if further reimbursement is valid.
  7. Compose technical denial arguments for reconsideration.
  8. Overcome objections to prevent payment of claims.
  9. Escalate exhausted appeal efforts to leadership.
  10. Submit retro authorization to insurance within carrier guidelines.
  11. Research and take necessary action to follow up on unpaid claims.
  12. Work pending claims in the CMS Direct Data Entry software and SPH claims Clearinghouse.
  13. Analyze insurance payments received to verify account was paid per contract.
  14. Use effective documentation standards to support a strong historical record of actions taken on the account.
  15. Review and follow through on credit balances.
  16. Report Medicare credits quarterly to Medicare.
  17. Log and adjust Medicare bad debt cancels.
  18. Work patient and insurance correspondence timely.
  19. Respond to all queries timely to ensure Gold Standard Customer Service.
Qualifications:
  • Previous work experience in insurance billing regulations and understanding insurance contracts preferred but not mandatory.
  • Knowledge of state and federal regulations as they relate to the billing process preferred but not mandatory.
  • Proficient keyboard/10 key skills and working knowledge of computers required.
  • Good verbal and written communication skills.
  • Strong data entry, ten key skills, and working knowledge of computer required.
  • Exceptional customer service and interpersonal communication skills.
  • Proficient in examining documents for accuracy and completeness.
  • Ability to multitask and manage time effectively.
  • Ability to grasp, retain, and apply new regulations.
  • Mathematical, organization skill, and business correspondence skills.
  • Basic knowledge in downloading/creating spreadsheets in Microsoft Excel.

High School diploma or GED required. Completes Patient Financial Services I training within first 5 months.

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